Arterial dissection is a deadly disease caused by a tear in the tunica intima of an artery, forming a fake lumen. A thin wall or septum resulting from the tear creates a double barrel portion of the artery, with blood flow on both sides of the septum. The false lumen is on one side of the septum while the true lumen is on the other side. Some arterial dissections can extend up to a meter in length. If untreated, death from rupture or downstream organ ischemia can occur. For patients that survive the initial episode, a chronic dissection occurs and often progresses to an aneurysm with significant aortic rupture risk.
The main surgical method for arterial dissection reconstruction involves open surgical exposure of the artery and associated branch vessels, clamping of the arteries, and then cutting through all three layers of the artery in order to access and repair the dissection. Often the surgeon adds a prosthetic graft to repair the artery wall and re-establish arterial continuity. Clamping arteries and cutting through healthy tissues to repair aortic dissections causes undesired consequences of extra stress placed on the heart with clamping, downstream organ dysfunction from lack of blood flow during clamping, and healthy tissue injury, such as nerve and lung injuries from surgical exposures.
US 2014/0012252 discloses a surgical cutting tool that is inserted into the artery mounted on a catheter. The tool has a blade for cutting a dissection septum. Other tools have been developed for insertion by a catheter into an artery for performing various functions. For example, water jet surgical devices are inserted into arteries on catheters to aspirate and macerate thrombus within an artery.